On the calculation of air-sea fluxes of CO2 in the presence of temperature and salinity gradients

The presence of vertical temperature and salinity gradients in the upper ocean and the occur- rence of variations in temperature and salinity on time scales from hours to many years complicate the calculation of the flux of carbon dioxide (CO2) across the sea surface. Temperature and salinity affect the interfacial concentration of aqueous CO2 primarily through their effect on solubility with lesser effects related to saturated vapor pressure and the relationship between fugacity and partial pressure. The effects of temperature and salinity profiles in the water column and changes in the aqueous concentration act primarily through the partitioning of the carbonate system. Climatological calculations of flux require atten- tion to variability in the upper ocean and to the limited validity of assuming ‘‘constant chemistry’’ in trans- forming measurements to climatological values. Contrary to some recent analysis, it is shown that the effect on CO2 fluxes of a cool skin on the sea surface is large and ubiquitous. An opposing effect on calculated fluxes is related to the occurrence of warm layers near the surface; this effect can be locally large but will usually coincide with periods of low exchange. A salty skin and salinity anomalies in the upper ocean also affect CO2 flux calculations, though these haline effects are generally weaker than the thermal effects

The OceanFlux Greenhouse Gases methodology for deriving a sea surface climatology of CO2 fugacity in support of air–sea gas flux studies

Climatologies, or long-term averages, of essential climate variables are useful for evaluating models and providing a baseline for studying anomalies. The Surface Ocean CO2 Atlas (SOCAT) has made millions of global underway sea surface measurements of CO2 publicly available, all in a uniform format and presented as fugacity, fCO2. As fCO2 is highly sensitive to temperature, the measurements are only valid for the instantaneous sea surface temperature (SST) that is measured concurrently with the in-water CO2 measurement. To create a climatology of fCO2 data suitable for calculating air–sea CO2 fluxes, it is therefore desirable to calculate fCO2 valid for a more consistent and averaged SST. This paper presents the OceanFlux Greenhouse Gases methodology for creating such a climatology. We recomputed SOCAT's fCO2 values for their respective measurement month and year using monthly composite SST data on a 1° × 1° grid from satellite Earth observation and then extrapolated the resulting fCO2 values to reference year 2010. The data were then spatially interpolated onto a 1° × 1° grid of the global oceans to produce 12 monthly fCO2 distributions for 2010, including the prediction errors of fCO2 produced by the spatial interpolation technique. The partial pressure of CO2 (pCO2) is also provided for those who prefer to use pCO2. The CO2 concentration difference between ocean and atmosphere is the thermodynamic driving force of the air–sea CO2 flux, and hence the presented fCO2 distributions can be used in air–sea gas flux calculations together with climatologies of other climate variables

FluxEngine: A Flexible Processing System for Calculating Atmosphere–Ocean Carbon Dioxide Gas Fluxes and Climatologies

The air–sea flux of greenhouse gases [e.g., carbon dioxide (CO2)] is a critical part of the climate system and a major factor in the biogeochemical development of the oceans. More accurate and higher-resolution calcu- lations of these gas fluxes are required if researchers are to fully understand and predict future climate. Satellite Earth observation is able to provide large spatial-scale datasets that can be used to study gas fluxes. However, the large storage requirements needed to host such data can restrict its use by the scientific com- munity. Fortunately, the development of cloud computing can provide a solution. This paper describes an open-source air–sea CO2 flux processing toolbox called the ‘‘FluxEngine,’’ designed for use on a cloud- computing infrastructure. The toolbox allows users to easily generate global and regional air–sea CO2 flux data from model, in situ, and Earth observation data, and its air–sea gas flux calculation is user configurable. Its current installation on the Nephalae Cloud allows users to easily exploit more than 8 TB of climate-quality Earth observation data for the derivation of gas fluxes. The resultant netCDF data output files contain .20 data layers containing the various stages of the flux calculation along with process indicator layers to aid interpretation of the data. This paper describes the toolbox design, which verifies the air–sea CO2 flux calculations; demon- strates the use of the tools for studying global and shelf sea air–sea fluxes; and describes future developments

Physicians Infrequently Adhere to Hepatitis Vaccination Guidelines for Chronic Liver Disease

Background and Goals:Hepatitis A (HAV) and hepatitis B (HBV) vaccination in patients with chronic liver disease is an accepted standard of care. We determined HAV and HBV vaccination rates in a tertiary care referral hepatology clinic and the impact of electronic health record (EHR)-based reminders on adherence to vaccination guidelines.Methods:We reviewed the records of 705 patients with chronic liver disease referred to our liver clinic in 2008 with at least two follow-up visits during the subsequent year. Demographics, referral source, etiology, and hepatitis serology were recorded. We determined whether eligible patients were offered vaccination and whether patients received vaccination. Barriers to vaccination were determined by a follow-up telephone interview.Results:HAV and HBV serologic testing prior to referral and at the liver clinic were performed in 14.5% and 17.7%; and 76.7% and 74% patients, respectively. Hepatologists recommended vaccination for HAV in 63% and for HBV in 59.7% of eligible patients. Patient demographics or disease etiology did not influence recommendation rates. Significant variability was observed in vaccination recommendation amongst individual providers (30-98.6%), which did not correlate with the number of patients seen by each physician. Vaccination recommendation rates were not different for Medicare patients with hepatitis C infection for whom a vaccination reminder was automatically generated by the EHR. Most patients who failed to get vaccination after recommendation offered no specific reason for noncompliance; insurance was a barrier in a minority.Conclusions:Hepatitis vaccination rates were suboptimal even in an academic, sub-speciality setting, with wide-variability in provider adherence to vaccination guidelines. © 2013 Thudi et al

PRESENT 2020: Text Expanding on the Checklist for Proper Reporting of Evidence in Sport and Exercise Nutrition Trials.

Some readers may not have access to the full paper, so a properly formatted and well-written abstract is imperative. Authors should give priority to information about the current study rather than using the abstract for an extensive background or rationale. 2a Methods: Key information regarding the study design, methods, and population should be summarized to enable broad understanding of the study from the abstract. 2b Results: Readers are interested in extracting key data that reflect the main findings of the study. The abstract should present data (e.g., the absolute magnitude of values and the size/precision of effects—specifying which measures of central tendency and variability are stated) rather than simply stating the presence, absence, or direction of effects. The presentation of p values or similar inferential statistics is no substitute for reporting actual data (Maughan, 2004). 2c Conclusion: Priority should be given to the reporting of results as per the previous section, with only a brief concluding statement thereafter. A concise conclusion based on what was actually measured in the study is preferred to speculative interpretations, with cautious use of language to avoid hyperbole or improper inference of causality (Brown et al., 2013). It is not appropriate or necessary to identify further research priorities here

Designing a patient-centered personal health record to promote preventive care

<p>Abstract</p> <p>Background</p> <p>Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential.</p> <p>Methods</p> <p>Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR) designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases.</p> <p>Results</p> <p>The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices). Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results, automatically issue patient reminders for overdue services, prompt clinicians about needed services, and formulate personalized prevention plans.</p> <p>Conclusions</p> <p>The IPHR demonstrates that a patient-centered personal health record that interfaces with the electronic medical record can give patients a high level of individualized guidance and be successfully adopted by busy primary care practices. Further study and refinement are necessary to make information systems even more patient-centered and to demonstrate their impact on care.</p> <p>Trial Registration</p> <p>Clinicaltrials.gov identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00589173">NCT00589173</a></p

Neurogenesis Drives Stimulus Decorrelation in a Model of the Olfactory Bulb

The reshaping and decorrelation of similar activity patterns by neuronal networks can enhance their discriminability, storage, and retrieval. How can such networks learn to decorrelate new complex patterns, as they arise in the olfactory system? Using a computational network model for the dominant neural populations of the olfactory bulb we show that fundamental aspects of the adult neurogenesis observed in the olfactory bulb -- the persistent addition of new inhibitory granule cells to the network, their activity-dependent survival, and the reciprocal character of their synapses with the principal mitral cells -- are sufficient to restructure the network and to alter its encoding of odor stimuli adaptively so as to reduce the correlations between the bulbar representations of similar stimuli. The decorrelation is quite robust with respect to various types of perturbations of the reciprocity. The model parsimoniously captures the experimentally observed role of neurogenesis in perceptual learning and the enhanced response of young granule cells to novel stimuli. Moreover, it makes specific predictions for the type of odor enrichment that should be effective in enhancing the ability of animals to discriminate similar odor mixtures

The antiinflammatory potential of phenolic compounds from Emblica officinalis L. in rat

Antiinflammatory effects of phenolic compounds from Emblica officinalis were evaluated in carrageenan and cotton pellet induced acute and chronic inflammatory animal model. Fractions of E. officinalis containing free (FPEO) and bounded (BPEO) phenolic compounds were assessed by HPLC technique. The free and bound phenolic compounds were studied for their acute and chronic antiinflammatory activity at dose level of 20 and 40 mg/kg. The carrageenan induced acute inflammation was assessed by measuring rat paw volume at different time of intervals. Further, cotton pellet induced chronic inflammation was assessed by granulomatous tissue mass estimation along with the estimation of tissue biomarker changes (i.e. lipid peroxidation, reduced glutathione, myeloperoxidase and plasma extravasation). The results indicated that in both acute and chronic inflammation, FPEO and BPEO show reduction in the inflammation, but significant effects was observed only at high doses of both fractions which was comparable to diclofenac treated group. In conclusion, phenolic compounds of E. officinalis may serve as potential herbal candidate for amelioration of acute and chronic inflammation due to their modulatory action of free radicals

Health-related and overall quality of life of patients with chronic hip and knee complaints in general practice

BACKGROUND: Information about quality of life of patients with chronic hip or knee complaints in general practice is scarce. This study describes the health-related and overall quality of life (HRQL) of these complaints. METHODS: Data were obtained from a cohort study in general practice. HRQL at three months follow-up was analysed. HRQL was measured as: symptoms, physical, psychological and social functioning, and general health perceptions, using the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the MOS 36-item short-form-health survey (SF-36). Overall quality of life was measured using a 5-point rating scale. RESULTS: The results show that patients with chronic hip or knee complaints have a substantial lower HRQL compared to patients who had recovered from baseline hip or knee complaints. The largest effect was found on symptoms and physical functioning: up to 2.9 standard deviations below patients who had recovered from baseline hip or knee complaints. Scores of patients with both chronic hip and knee complaints were significantly worse than scores of patients with only knee complaints on most subscales. CONCLUSION: In patients with chronic hip or knee complaints the worst scores were seen on scales that measure symptoms and physical functioning, but still a substantially lower score was obtained for overall quality of life. Quality of life was poorer for patients with both chronic hip and knee complaints compared to those with chronic hip or knee complaints onl

Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339]

BACKGROUND: Osteoarthritis (OA) has a high prevalence in primary care. Conservative, guideline orientated approaches aiming at improving pain treatment and increasing physical activity, have been proven to be effective in several contexts outside the primary care setting, as for instance the Arthritis Self management Programs (ASMPs). But it remains unclear if these comprehensive evidence based approaches can improve patients' quality of life if they are provided in a primary care setting. METHODS/DESIGN: PraxArt is a cluster randomised controlled trial with GPs as the unit of randomisation. The aim of the study is to evaluate the impact of a comprehensive evidence based medical education of GPs on individual care and patients' quality of life. 75 GPs were randomised either to intervention group I or II or to a control group. Each GP will include 15 patients suffering from osteoarthritis according to the criteria of ACR. In intervention group I GPs will receive medical education and patient education leaflets including a physical exercise program. In intervention group II the same is provided, but in addition a practice nurse will be trained to monitor via monthly telephone calls adherence to GPs prescriptions and advices and ask about increasing pain and possible side effects of medication. In the control group no intervention will be applied at all. Main outcome measurement for patients' QoL is the GERMAN-AIMS2-SF questionnaire. In addition data about patients' satisfaction (using a modified EUROPEP-tool), medication, health care utilization, comorbidity, physical activity and depression (using PHQ-9) will be retrieved. Measurements (pre data collection) will take place in months I-III, starting in June 2005. Post data collection will be performed after 6 months. DISCUSSION: Despite the high prevalence and increasing incidence, comprehensive and evidence based treatment approaches for OA in a primary care setting are neither established nor evaluated in Germany. If the evaluation of the presented approach reveals a clear benefit it is planned to provide this GP-centred interventions on a much larger scale